As we head into the holidays, we wish you and yours a joyful and safe season.
Keep safety top of mind—on the road and in our communities. December marks National Impaired Driving Awareness Month, a reminder to make responsible choices and help protect one another.
Whether you're heading to a gathering or returning home to loved ones, please avoid driving under the influence of alcohol, cannabis, prescription medications, or other substances such as nitrous oxide. Impaired driving puts lives at risk and can have lasting consequences.
🎥 Click the image below to view a special holiday message from Dr. Jonathan Watson, Medical Director with Correctional Health Services reminding us all to celebrate safely and protect one another.
Stay safe, stay healthy, and enjoy a wonderful holiday season!
Dr. Jonathan Watson is dual Board-Certified in Family Medicine and Addiction Medicine and is the Medical Director of Orange County Correctional Health Services. He first discovered his passion for addiction care while working as a case manager in San Francisco’s Tenderloin neighborhood. He attended Harvard Medical School before pursuing his family medicine training at Harbor-UCLA Medical Center and then an addiction medicine Fellowship at UCLA. Dr. Watson’s love of teaching has pushed him to maintain volunteer clinical professor roles with UC Irvine’s Department of Family Medicine and Loma Linda University’s Department of Preventive Medicine. Dr. Watson has remained active with the California Society of Addiction Medicine.
Over the past month, influenza test positivity has steadily increased. Emergency department visits for influenza and RSV are also increasing. Although hospital admissions for these illnesses are increasing, overall hospitalization rates remain low. Notably, fewer influenza vaccines have been administered this year compared to the same period last year.
Currently, COVID-19 activity, as measured by percent positivity, remains low—lower than during the same period in each of the past five seasons.
Avian influenza A(H5N1) detections continue among wild birds and backyard poultry in the United States. Providers should evaluate patients with acute respiratory symptoms or conjunctivitis for avian influenza, especially if they have had recent exposure to animals or individuals suspected or confirmed to have the virus or have consumed raw dairy products. More info...
The Centers for Disease Control and Prevention (CDC) is issuing this Health Alert Network (HAN) Health Advisory to inform clinicians and health departments about a new outbreak of Marburg virus disease (MVD) in Ethiopia’s South Ethiopia and Sidama regions. MVD is a severe illness that can be fatal.
No suspected, probable, or confirmed cases of MVD related to this outbreak have been reported in the United States or other countries outside of Ethiopia as of December 3, 2025. The risk of spread to the United States is considered low at this time; however, clinicians should be aware of the potential for imported cases. As a precaution, this health advisory summarizes CDC’s recommendations about MVD case identification, testing, and biosafety considerations in clinical laboratories for U.S. health departments, clinical laboratories, and healthcare workers.
On November 17, 2025, CDC issued a Level 1 Travel Health Notice, advising people traveling to Ethiopia to practice usual precautions. The notice advises travelers to check their health for signs or symptoms of MVD while in the outbreak area and for 21 days after leaving and take appropriate actions (isolate, avoid travel, seek health care) if they become ill. Ethiopian national authorities are increasing response activities including screening, isolation of cases, contact tracing, airport exit screening, and public awareness campaigns to curb the spread of MVD. As of December 3, 2025, CDC is not recommending additional assessments or monitoring of travelers arriving from Ethiopia by the jurisdictional health departments.
World AIDS Day has been commemorated every December 1st since 1988. It is dedicated to spread awareness of the AIDS epidemic, to acknowledge all those living with HIV and to mourn all that have died of the disease.
World HIV/AIDS
Since 1988, 44 million people worldwide have died of AIDS and 40.8 million were living with HIV in 2024. There have been remarkable advances in HIV treatment, but HIV still claimed 630,000 lives in 2024. Despite advances in medications to prevent HIV infection, 1.3 million acquired HIV in 2024.
The theme of this year’s World AIDS Day is “Overcoming disruption, transforming the AIDS response.” This highlights the impact that funding cuts have had on the global HIV response. The cuts from international donors have threatened to undo decades of progress in HIV treatment and severely disrupt HIV prevention efforts.
The Joint United Nations Programme on HIV/AIDS (UNAIDS) calls for “sustained political leadership, international cooperation and human-rights-centered approaches to end AIDS by 2030.”
Orange County HIV
In Orange County, there were 6,955 persons living with HIV (PLWH) in 2024 that were aware of their status and an estimated additional 1,706 persons who are unaware they have HIV. The Centers for Disease Control and Prevention (CDC) estimates that 80.3% of PLWH know their status.
In 2024, 230 individuals in Orange County were newly diagnosed with HIV. This is a 14.8% decrease from 2020. Of these 230 people, 56 were diagnosed with AIDS at the time of their HIV diagnosis. This indicates they were likely infected for many years before getting tested.
Preventing HIV
Medications to prevent HIV are highly effective. These medications are called PrEP or pre-exposure prophylaxis. When the pills are taken on a regular basis, they are 99% effective to prevent getting infected. This year a new PrEP injection medication, Yeztugo (lenacapavir), was approved by the Food and Drug Administration. It is given as an injection under the skin but is only needed every 6 months. Those who are at risk of HIV infection need to know of the availability of PrEP no matter their insurance status.
Treating HIV
The advances in HIV treatment over the past two decades have changed the face of HIV care. It is now a very manageable, chronic disease. Most patients only have to take one pill, once-a-day and almost all patients can eliminate the virus completely from their blood. This is called being undetectable. When a person is undetectable, laboratory testing cannot detect any of the virus in the person’s blood. Without virus in the blood, the disease does not progress and the person remains healthy.
When a person is on medication and undetectable, they cannot pass the disease on to their sex partners. This concept is called U=U, undetectable mean untransmittable. You can learn more about U=U by clicking here.
Image
HIVPAC_Untracable_Undetectable.jpg
Testing for HIV
A person can live a very long healthy life with HIV in 2025. It is a disease that is easily treated. But people need to know their HIV status so they can start treatment early, long before they might get sick. The CDC recommends everyone aged 13 to 64 get tested at least once as part of routine health care. Testing more frequently, every 3 to 6 months, is recommended for those at higher risk, especially gay or bisexual men, those with multiple sex partners and those who share needles during drug use.
On this 37th annual World AIDS Day, let’s reaffirm our collective commitment to ending the HIV epidemic:
It’s essential to ensure continued support and funding for HIV prevention and treatment programs.
Let’s talk openly about HIV, reduce stigma, and encourage testing for ourselves and our loved ones.
Help protect those at risk by increasing access to PrEP (pre-exposure prophylaxis).
And work to connect individuals living with HIV to life-saving treatment as early as possible.
Dr. Christopher Ried graduated from UC Berkeley and the UCLA School of Medicine. He did his residency at the UCLA/West LA Veterans Administration Medical Center and is Board Certified in Internal Medicine. He has been providing HIV care to the medically underserved for 34 years. For the past 25 years he has been the Medical Director of HIV/STD in the Public Health Services Division of the OC Health Care Agency.
This advisory is being issued in response to the recent update to Title 17 of the California Code of Regulations, which now designates silicosis as a reportable disease. As of July 2025, healthcare providers are required to report confirmed or suspected cases of silicosis to the local health department within seven calendar days of identification.
Silicosis cases among countertop fabrication workers in California—particularly those working with engineered stone (commonly used in "quartz countertops")— have continued to rise. Since 2019, the California Department of Public Health (CDPH) has conducted statewide, multi-source surveillance and has identified 432 confirmed cases of silicosis associated with engineered stone exposure as of November 13, 2025. Alarmingly, at least 25 workers have died, many in their 30s and 40s, and 48 have undergone lung transplants
Healthcare providers should:
Screen for occupational exposure by asking patients about current and past work in countertop fabrication or similar industries.
Follow current diagnostic guidelines, including imaging and pulmonary function testing, and refer patients early for specialized care.
Report all confirmed or suspected cases to the local health department in the patient’s county of residence within 7 calendar days.
(Santa Ana, CA) — A recently released report from the Orange County Sheriff-Coroner shows a decrease in fentanyl-related deaths, marking a five-year low in the county.
The OC Sheriff Coroner Division report shows there were 407 fentanyl-related deaths in 2024, down from 613 deaths in 2023. The numbers reported so far for 2025 are continuing to show a downward trend.
“Seeing a progressive drop in the number of fentanyl-related deaths is encouraging and a testament to the collaborative work of the Sheriff’s Department and the County in addressing this complex and challenging issue,” said Don Barnes, Orange County Sheriff-Coroner. “However, our work is far from done. We will continue to work together to be innovative and effective in fighting fentanyl.”
From programming to enforcement to legislative efforts, the County of Orange (County) has dedicated numerous resources over the last decade that have contributed to the countywide reduction in fentanyl-related deaths, including efforts by the Board of Supervisors, the Orange County Sheriff’s Department, and the OC Health Care Agency (HCA).
“I am encouraged and hopeful that the collective efforts by our County are making an impact in the fight against fentanyl,” said Chair Doug Chaffee, Fourth District. “The fight isn’t over, so we will continue in these efforts to save lives and protect our community.”
The OC Sheriff has intensified enforcement efforts to dismantle the networks responsible for introducing fentanyl and other dangerous narcotics into our communities. Last year, narcotics teams seized more than 184 pounds of fentanyl powder and nearly 45,300 fentanyl pills.
In addition, beginning in 2021, the OC Sheriff began investigating all drug-related overdoses as possible homicides in an effort to hold drug dealers accountable. Since then, multiple cases have been submitted for prosecution at both the local and federal levels.
"Any life lost to fentanyl abuse is one too many. I commend the collective efforts by County departments and my office to educate the community and distribute naloxone to help reduce fentanyl deaths amongst our Orange County youth,” stated Vice Chair Katrina Foley, Fifth District. “From here, we must continue prioritizing treatment and holding drug traffickers accountable for poisoning our young adults.”
In the custody setting, a strong partnership with the HCA’s Correctional Health Services (CHS) team has led to the implementation of additional screening, treatment, and programs to address substance use disorder in Orange County’s jails. The two-pronged strategy of enforcement, along with treatment and recovery services, is critical to saving lives and supporting long-term recovery across Orange County.
“My office is committed to Orange County’s prevention and education efforts to combat the fentanyl epidemic,” said Supervisor Janet Nguyen, First District. “I’m excited to hear that our efforts are resulting in reduced deaths associated with this deadly drug. I have been fighting for years to draw attention to this crisis, including writing a law that dramatically increases the prison sentences for fentanyl dealers.”
Over the last four years, the HCA launched two major media campaigns against fentanyl and other deadly drugs impacting Orange County. Both campaigns were comprehensive initiatives aimed at raising awareness about the critical issues of fentanyl misuse. They included outreach efforts and educational materials on prevention and rescue resources to empower the public to access local resources for assistance. The campaigns included: • The “Life is Greater Than Drugs” which targeted OC youth to showcase life with music, sports, artistic and creative dreams versus a life misusing drugs like opioids and fentanyl, causing devastating loss of those dreams. Visit www.lifeisgreaterthandrugs.com. • The “Fentanyl is Forever” campaign targets all OC residents, speaking to families, friends, and providers to drive awareness of the dangers of fentanyl and empower the public to access local resources for assistance. Visit www.fentanylisforeveroc.org.
“These continued reductions are very encouraging for my district, where fentanyl-related deaths have been a scourge on our communities,” stated Supervisor Vicente Sarmiento, Second District. “We know that many of these overdose deaths are preventable, and that outreach and distribution of medication to affected populations are key drivers of these results. The combined efforts of the County teams are working and support our commitment to continue the momentum.”
The use of Medication Assisted Treatment (MAT) is helping to rebuild and save the lives of individuals with substance use disorders, both for the general population and for the populations in custody settings. In OC, robust intake screening and MAT provide support for jail and medical staff to assist those with substance use disorder. Additionally, all incarcerated persons in MAT receive training on Naloxone, the opioid antagonist that can reverse the effects of an overdose, and every person released from custody is supplied with Naloxone.
“It's incredibly reassuring to see lives being saved due to the efforts of the legislation we have supported and by the hard work done by the County and its departments,” shared Supervisor Donald P. Wagner, Third District. “Fighting to protect our residents from this poisonous killer of our young people is something everyone can – and should – get behind.”
“In addition to jail programming and services, the HCA takes a comprehensive approach to addressing substance use disorders and, specifically, fentanyl use,” said HCA Director, Dr. Veronica Kelley. “We have strong collaborative partnerships with our Sheriff’s Department and Board offices, and have implemented strategies to care for the clients, including incarcerated individuals, to ensure they receive the care and support they need so they can begin recovery and rehabilitation.”
If you or someone you know is struggling with substance use, there are many resources to help combat issues with drugs or alcohol. Visit www.ocnavigator.org.
Image
oc_fentanyl-related_deaths.png
ABOUT THE OC HEALTH CARE AGENCY The OC Health Care Agency (HCA) is a regional interdisciplinary health jurisdiction and an accredited health department, charged with protecting and promoting individual, family and community health through partnership and coordination of public and private sector resources. Visit www.ochealthinfo.com to learn more about services and resources.
The California Department of Public Health (CDPH), the Center for Disease Control and Prevent (CDC) and multiple other states continue to investigate a large, multi-state outbreak, of infant botulism linked to at least two lots of ByHeart Whole nutrition infant formula. The manufacturer has now expanded their voluntary recall to all ByHeart formula nationwide - this includes both cans and single-serve Anywhere Pack™ sticks. Consumers with this product should stop using it immediately. Physicians with a suspected case of infant botulism may reach California’s Infant Botulism Treatment and Prevention Program at (510) 231-7600 at any time. Parents with concerns or questions about suspected infant botulism should seek medical advice immediately.
The California Department of Public Health is working with other state health departments and the U.S. Centers for Disease Control and Prevention to investigate a multistate outbreak of infant botulism linked to ByHeart Whole Nutrition Infant Formula. To date, 15 cases have been reported in the United States, including two in California. No cases have been reported from Orange County currently. See web link below for more information. The company has recalled two lots of its product. Consumers with this product should stop using it immediately. Physicians with a suspected case of infant botulism may reach California’s Infant Botulism Treatment and Prevention Program at (510) 231-7600 at any time. Parents with concerns or questions about suspected infant botulism should seek medical advice immediately.
Picture-perfect decorations, families dressed in matching holiday outfits laughing together in front of a cozy fireplace, snow falling outside the window—this is what the holidays look like in commercials and social media. However, in real life the holidays are the most stressful time of the year for many people, and a time when underlying anxiety and depression can become worse. Common causes of increased stress include financial concerns, family conflicts, increased feelings of grief or loneliness, and unrealistic pressures to be perfect when it comes to hosting, decorating, and choosing gifts. I’ve recently learned that even a popular tradition of seeing where a magical elf ends up each night in the home can be a daily stressor for parents, especially when the elf “forgets” to move to a new location.
Here are my 7 favorite tips for surviving the holidays:
1. Simplify your holiday routine
Think about what stressed you out during the last holiday season and consider making a change this year. Are you always scrambling to get holiday cards mailed out in December? Consider skipping the cards this year, sending a digital card, or making a “Happy New Year” card instead. Stressed about trying to find the perfect gift for everyone in your family? Ask them to switch to a White Elephant gift exchange or try using a gifting app where everyone can input their wish lists and track which items are purchased.
2. Keep your self-care routine
You may be focused on doing things for others, but please remember to take care of yourself first. This means trying to stay on a regular sleep schedule, eating balanced meals (with the occasional delicious holiday treat!), getting regular physical activity, and avoiding excessive use of alcohol or other substances. I also recommend making a “fun to-do list” of activities that make you feel relaxed and happy, like watching your favorite movie or snuggling your pet on the couch. Refer to this list when you’re stressed and set aside time to do one of these activities after a stressful event.
3. Don’t be afraid to set boundaries with others
Holiday gatherings can be a source of frustration when people ask intrusive personal questions, start political debates, or bring up sensitive topics. Remember that it’s okay to tell someone that you’re uncomfortable with a certain topic and don’t want to talk about it. It’s okay to “agree to disagree.” If verbal attempts to change the subject don’t work, you can always excuse yourself and go to another room to calm down.
4. Go outside and exercise
In Southern California, we’re lucky to be able to enjoy sunshine, blue skies, and ocean views year-round. Research studies have found that being in nature for just 20 minutes can lower cortisol levels, the main stress hormone in our body. Physical activity increases the release of natural “feel good” chemicals in our brain called endorphins, which can increase feelings of happiness and reduce pain. If you’re not sure where to go in Orange County (OC), visit the OC Parks website for information on parks, beaches, zoos, and historic sites: https://www.ocparks.com/.
5. Allow yourself to grieve
The holidays are a time when people are reminded of the loved ones they lost. This is especially hard if it’s the first holiday season without them. You may feel fine one moment and then see something that makes you cry, and that’s okay. Do what you feel is best for you, even if it means skipping a holiday event to stay in and binge your favorite show. For some, it can be helpful to share fond memories with close family and friends or continue a holiday tradition that the person enjoyed. For others, it might be best to seek a support group or grief counselor to learn how to cope with the pain.
6. Connect with the community
For people who don’t have a close support network of friends and family in their area, connecting with the community can help provide that support. Options include joining a local walking club, sports league, cultural center, or faith community. Volunteering is also a great way to feel a sense of purpose while helping others in need. If you’re interested in OC volunteering opportunities, you can visit: County of Orange Volunteer Opportunities.
7. Ask for help when you need it
If your mental health struggles are becoming too overwhelming to handle on your own, don’t be afraid to ask for help! Here are some resources that are available:
National Alliance on Mental Illness (NAMI): Provides support and education for individuals with mental illness and their loved ones.
Angela Yu, MD, is a Board-Certified Psychiatrist and the Associate Medical Director for the Adult & Older Adult Behavioral Health Services at the OC Health Care Agency. She is a Midwest native who completed medical school at the University of Missouri, then moved to California for her residency training at UC-Irvine. During her training, she developed a passion for community mental health after rotating at clinics and homeless shelters which provided services to the underserved. She chose to work for the OC Health Care Agency in 2014 so she could continue to help individuals with severe mental illness. In relation to her article about holiday wellness, she is currently contemplating whether to introduce the magical elf tradition to her home and she welcomes all advice on how to make this tradition as stress-free as possible.
(Santa Ana, CA) — An Anaheim resident over the age of 80 has tested positive for West Nile virus (WNV), marking the first confirmed human WNV case in Orange County this year. The person experienced headache and neurologic symptoms and was hospitalized with encephalitis, a serious brain inflammation linked to the virus. Orange County reported just one human case of West Nile virus and no related deaths in 2024.
“West Nile virus is common in Orange County, recurring every year during the summer months and continuing into the fall,” said Dr. Regina Chinsio-Kwong, County Health Officer. "The best way to avoid West Nile virus infection is to take precautionary measures to avoid mosquito bites.”
Recommended WNV precautions include: • Emptying all standing water on your property to reduce areas in which mosquitoes may breed, including flowerpot saucers and pet bowls. • Making sure your window and door screens are in good condition. • Using insect repellent containing DEET, picaridin, oil of lemon eucalyptus, or products containing IR3535, always following label directions. • Limiting outdoor activity at dawn and dusk when mosquitoes are most active. • Wearing long-sleeved shirts and long pants when outdoors.
Most people who become infected with WNV do not experience symptoms. However one in five may develop fever and may have headache, body aches, nausea, tiredness and sometimes a skin rash. In rare cases, WNV can lead to serious complications such as encephalitis (inflammation of the brain). Symptoms of severe illness may include: severe headaches, neck stiffness, confusion, muscle weakness or paralysis. Anyone experiencing these symptoms should seek immediate medical care. People over 50 years of age and those with certain medical conditions are at higher risk of serious illness from WNV infection.
ABOUT THE OC HEALTH CARE AGENCY The OC Health Care Agency (HCA) is a regional interdisciplinary health jurisdiction and an accredited health department, charged with protecting and promoting individual, family and community health through partnership and coordination of public and private sector resources. Visit www.ochealthinfo.com to learn more about services and resources.
